Lifetime Risk of Atrial Fibrillation by Race and Socioeconomic Status

Abstract

BACKGROUND:Limited information exists on the lifetime risk of atrial fibrillation (AF) in African Americans and by socioeconomic status. METHODS:We studied 15 343 participants without AF at baseline from the ARIC (Atherosclerosis Risk in Communities) cohort recruited in 1987 to 1989 from 4 communities in the United States when they were 45 to 64 years of age. Participants have been followed through 2014. Incidence rates of AF were calculated dividing the number of new cases by personyears of follow-up. Lifetime risk of AF was estimated by a modified Kaplan-Meier method considering death as a competing risk. Participants' family income and education were obtained at baseline. RESULTS:We identified 2760 AF cases during a mean follow-up of 21 years. Lifetime risk of AF was 36% (95% confidence interval, 32%-38%) in white men, 30% (95% confidence interval, 26%-32%) in white women, 21% (95% confidence interval, 13%-24%) in African American men, and 22% (95% confidence interval, 16%-25%) in African American women. Regardless of race and sex, incidence rates of AF decreased from the lowest to the highest categories of income and education. In contrast, lifetime risk of AF increased in individuals with higher income and education in most sex-race groups. Cumulative incidence of AF was lower in those with higher income and education compared with their low socioeconomic status counterparts through earlier life but was reversed after age 80.

Ethnicity, heart failure, atrial fibrillation and diabetes: collider bias

“…Several studies have shown a lower prevalence of AF in Asian people,12–14 and others have shown a lower rate in American-Africans 15. The work here does not rule out the contribution of genotypically driven/haplotype background-derived effects on the prevalence and architecture of AF in HF cases, however this is clearly not a definitive evidence base.…”

Socioeconomic position and risk of atrial fibrillation: a nationwide Danish cohort study

“…The causal pathway linking SEP to AF has not been thoroughly investigated and it may differ for education and income (see figure 4). There is no obvious direct biological mechanism for the observed association between low education and higher risk of AF 9 25–27. However, the association may be explained by intermediate variables.…”

Clinical scores used for the prediction of negative events in patients undergoing catheter ablation for atrial fibrillation

“…The MB-LATER score good predictive ability for VLRAF could be partly explained by higher AF prevalence in men. 40,41…”